Emergency surgery for colorectal cancer (CRC) in patients over eighty

Aim: The aim of the study is to assess clinical features and postoperative outcomes in older patients treated for CRC. Method: 494 patients who underwent curative resection for CRC were enrolled in this study. 159 patients were over 80 years-old (GroupA), 335 patients were younger (GroupB). Patients’ demographic, clinical and histo-pathological parameters, intra- and perioperative results were entered into a database and analysed. Statistical analysis was performed with SPSS v13.0; significance was defined as P < 0.05. Results: In GroupA 83 patients underwent emergency procedures (52%), in GroupB 104 patients (31%) (P < 0.001). We observed significant differences between the two groups in comorbidities, emergency presentation, intraoperative blood transfusions, laparoscopic approach and mortality (P < 0.001). There were no differences in the number of radical resection and number of lymph-nodes isolated. However, multivariate logistic regression analysis showed that age ≥80 is an independent predictor of mortality (P = 0.004 OR 5.394) but not an independent predictor of morbidity (P = 0.6 OR 1.109). Conclusion: Old age ≥80 does not represent a contraindication for CRC surgery though associated with higher morbidity and mortality, in particular in emergency setting. It is advisable to reduce emergency procedures with multidisciplinary approach (enlargement of screening in old patients and stenting as-bridge-to-surgery in obstructions).